My midwives just called me today. When I tested posted for Group B Strep, I asked Angel (the midwife I was seeing) whether I could do oral antibiotics prior to labor instead of IV antibiotics. I told her I knew it was against conventional medical advice, but that I was fairly certain I would be turning down IV antibiotics at labor due to my phobia, and taking the oral antibiotics couldn’t hurt and might be a good compromise. Last time, with Micah, I was on the oral antibiotics (due to the chronic Group B Strep UTIs) and turned down the IV antibiotics. Everything turned out fine. I even had a negative Group B Strep swab just prior to labor, which helped me feel that I was making a safe choice. The risk of transmission is actually fairly low in the absence of a fever, active infection, and labor shorter than 18 hours, so I feel comfortable with my choice. I was in labor with Micah for 6 hours, and we expect this labor will go quickly this time, too. Honestly, with a short labor, they may not even be able to get in an IV and deliver the antibiotics to me at the hospital before the baby is born. They also recommend 2-3 doses prior to the birth of the baby for full effectiveness, and that requires at least 8-10 hours.
Angel said she needed to discuss things with Chris and Sharon, the other midwives who treated me last time. Well, she called back this morning, and they are calling in the antibiotics! I have to sign a form indicating that I have been advised to take IV antibiotics and I am declining, but they are “working with me” in my refusal to take the recommended course of action. This was a wink, wink, nod, nod situation – they have to recommend what the AMA standard is, but they are doing their best to support my decision without endorsing it. I cannot tell you how much I appreciate that!
Naturally, I’ve done my research. There are a number of studies indicating that oral antibiotics, when taken prior to labor and maintained until delivery, are just as effective (and perhaps more so) than IV antibiotics. There are also studies indicating that if the antibiotics are stopped, they are not effective at all. They key is no lapse in the antibiotics allowing time for the Group B Strep to re-grow. There are also studies that indicate IV antibiotics for women with short labors fail to reduce the risk of transmission of the Group B strep because there is insufficient time to for the medicine to work before the baby passes through the birth canal. So, in my opinion, this really is the smartest option for me. That is a HUGE relief for me!! Can I get some credit for being rational in my crazy phobia?